I'm Tom Mather, a.k.a. the TickGuy from URI. I'm a professor of public health entomology working at the University of Rhode Island. When RW contacted me to help with their July 2014 Lyme disease story, I saw the opportunity to link two of my passions…preventing tick bites and tickborne disease, and running. I've been a tick biologist since 1983 but a runner since 1982, and have finished 40 marathons, including 22 Boston Marathons. Most runners probably think very little about ticks while they're running, and that usually goes for me, too. Unless, for example, I need to pull off for a pit stop in the woods, or am running on trails. Then my tick "consciousness" clicks in and I do consider the possibility of ticks latching on.
Our TickEncounter website is loaded with helpful tick prevention tips, best practices, tick id tools, and a blog. Probably, the most important things runners can do to stay TickSafe while running is to treat their shoes with permethrin tick repellent and, of course, do a quick check after coming out of the woods and a more thorough full-body check at least once a day. But there are likely other questions you have about ticks and preventing bites and disease. One thing—I'm not a MD and while I've had Lyme (hazard of the job when you work with ticks) I won't be answering questions on diagnosis or therapy. But feel free to ask questions about ticks, what to look for and where to look, how best to prevent tick bites on people and pets, what to do if bitten (always take a picture of the tick) and how you can Get TickSmart to stay TickSafe all year ‘round.
Don't let Lyme slow down YOUR race time... Get TickSmart!
Mile1: Wow! Impressive topic for discussion on behalf of you and RunnersWorld. Thanks for taking the podium. OK, What is Lyme disease and is this the only worry from ticks? We live in Illinois. Is there a growing problem with ticks here? Thanks again for taking time to "Ask Me Anything!"
The TickGuy: Lyme is caused by an infection with a particular type of bacteria, called Borrelia burgdorferi. Only certain types of ticks -- blacklegged ticks -- transmit this particular bacteria to people and pets. There are other types of ticks out there across America and they can transmit other nasty, disease-causing germs, but certainly blacklegged tick associated infections like Lyme, Anaplasmosis, Babesiosis, and a couple of more recently identified infections (a relapsing fever-causing agent, and a virus) are most common. Find out what types of ticks are Current Tick Activity where you live.
DrBart: Thank you for providing this info, TickGuy! In 2006, I was in D.C. Area (Greenbelt, MD) for work. There was a lovely wooded park across the road from my hotel where I indulged in my daily run. Being a somewhat populated area, ticks and wildlife were the farthest from my mind. The morning I was to return home, I hopped in the shower before heading out to the airport. With soap on washcloth, I saw a speck of dirt that didn't seem to want to come out no matter how hard I scrubbed. On second (or third, maybe forth) look, I saw that it was something else. There at the top of my thigh/crease of leg was the tiniest of ticks. It was maybe the size of a poppy seed. I was grossed out and my initial reaction was to quickly pluck it loose and down the drain it went. Life went on and I didn't think much more about it.
....until 1 week later when I developed flu-like symptoms (fever, headache, vomiting....pretty much felt like I just wanted to crawl under a rock and die). I had a very large inguinal lymph node near where the tick had been and only then did I even think about the tick bite. My husband took me to the hospital where I was diagnosed with both acute Lyme (with cardiac manifestation) and babesia microti. Since these diseases are not endemic where I live, I feel very fortunate to have had a treating doc from the NE more familiar with these diseases. I didn't start developing the classic bulls-eye rash until I was extremely sick. I now realize how much more helpful it may have been had I taken time to save the tick (vs freak out and throw it down the drain). After 8 miserable days in the hospital, I was finally able to go home. I never imagined that a stupid, teeny, seemingly insignificant tick bite could be so awful!
I wonder how things might have turned out differently had I not even seen the tick to alert the doc to this possibility. If the tick was in my hair, seems like it would be extremely difficult to detect. Any tips for finding ticks in hard-to-look places? Also, what is the best way to save/preserve a tick in the event one gets sick after a bite?
The TickGuy: And that's how it happens...a seemingly innocent encounter. That's why prevention (permethrin-treated shoes; daily tick checks) are key. With more ticks carrying disease in more places (like right along the road where I run almost daily) daily tick checks need to become a daily hygiene practice like brushing your teeth and wiping your butt . We have daily tickcheck reminders to place in your bathroom, so that when you're naked, you think to look. For runners, get in an extra stretch by bending at the waist and looking between your legs while standing in front of a full length mirror. Look for a poppy seed like you mentioned; nymph stage deer ticks latch on at shoe level and crawl up until stopped by skin folds or clothing constrictions. Adult ticks latch on higher -- about knee level -- and crawl up, often under shirts only to get blocked in underarms, by bra straps, or maybe the hairline. The more aggressive American dog tick often will make it up to the crown of your head. Store ticks in sealed ziplock bags with the date found. Take a picture and send it to our TickSpotters program and we'll try and provide an assessment of how "risky" that tick might be.
ShuffleFaster: 1. Does using a spray insect repellant (like "Deep Woods Off") just before a run help ward off ticks as well? 2. Does the "Insect Shield" service advertised on your site work on running clothing without affecting the wicking and drying properties of the clothing? Thanks!
The TickGuy: Repellent applied to skin may help a little but it appears to work better against mosquitoes than ticks. Not certain about whether the Insect Shield treatment affects wicking and drying properties of runners clothes. I do know that they regularly treat high end technical clothing for uses like backpacking and hiking, and clothing with UV blocking treatments. I'll ask and try to get back on this point.
Rcl2884: Thanks, Tick Guy! Interesting subject. I do a lot of trail running in Maine, and so consider myself in some tick danger, but have never done much for prevention, other than check for ticks after running. I know many people here who have contacted Lyme disease, including my wife, and so consider myself lucky that I have not. I have a couple of questions.
Are there individual differences in susceptibility to Lyme? i.e. some people are prone and some are not? Is this a new disease? I never remember hearing about Lyme as a child... was there a mutation in the last several decades that produced the bacteria that causes Lyme?
The TickGuy: Lyme borrelia DNA has been detected in a 5000 year old ice man and was found in ticks and mouse skins stored in a Harvard museum from the mid-1800s. Lyme is a zoonosis--happily maintained in wildlife until some factor allows it to spill-over and affect humans. That factor is more vector ticks--specifically deer ticks. Deer tick populations are more abundant now than probably at any time in the history of the United States. Since the early 1900s, various factors have allowed deer populations to grow in rural, suburban and even semi-urban settings, and these animals more than any other are the key reproductive hosts for deer ticks. More deer in more places means more deer ticks in more places...and the risk of deer tick transmitted diseases like Lyme.
paul2432: Do you have any specific recommendations for tick safety with children? My daughters are 5 and 8. We live in Thousand Oaks, CA. (looks like CA is low risk compared to elsewhere).
Does the drought increase or reduce tick activity? How do I do a the daily tick inspection? Just look all over for small black spots?
What is your marathon PR and how did you train for it?
The TickGuy: Do daily tick checks and have them wearing tick repellent clothing, especially for higher tick encounter risk activities like camp, hiking trails, but even walking a dog in tick habitat. We were in your area a couple of years ago, sampling ticks in the Santa Monica hills and in parklands and dog parks. Western blacklegged ticks are a little more drought tolerant than its eastern deer tick cousin, but neither do well in drought conditions. Your blacklegged tick season this year started strong in December but has pretty much petered out now. Dog ticks and Pacific Coast ticks are still abundant and can transmit infections as well, just not Lyme. We have guidance for doing Daily TickChecks -- it's important to learn where to look and what to look for.
It's been awhile for any PRs but my best was Boston 1987. Seiko won but I ran 2:32 . Thanks for asking.
mudpuddlejumper: hey, tick guy! (yeesh. it would be so much nicer to type "hey, luna moth guy! or "hey, monarch butterfly guy!") but no offense meant. entomology is a crazy cool study. Ticks are seriously icky and it is very nice of you offering your expertise on the subject. :-)
speaking of the subject...where do ticks hang out when they AREN'T on deer and doggies and how do they find us on the trails? do they start on our shoes, trek up our legs (eeeewwww!) and then look for yummy spots to munch? they don't fall from the treetops or birds, do they? we do have LOTS of deer in the NE but it's not like deer seek people out to get them in close tick contact. my son and i are running on the trails all the time now and all i really do, for protection, is zap our shoes and legs with a tick repellent spray. green mountain something...is that good enough? thanks so much for your feedback, tom!
The TickGuy: Not sure of the active ingredients in your green mountain something but we've found very low impact of many of the "natural" active ingredients against ticks. Ticks are adapted to do their host seeking where they can maximize the likelihood of contacting their preferred host. Ticks can't fly and they don't jump or drop from trees. They generally need to have contact with humid conditions for re-hydrating daily but they do need to "get themselves out there" enough to find a host, because they can't grow or reproduce without a blood meal. So adult deer ticks prefer deer, and the largest surface on a deer is at about its flank or belly; that's about 2-3 ft off the ground and that's where you can find this stage of the tick host seeking. The nymph stage is particularly prone to desiccating so needs to stay in the more humid leaf litter, but that's ok since small rodents and ground feeding birds also frequent that habitat. It's important to know the types of ticks that occur where you live and when during the year the different stages are active. That can help you avoid contact and also how better to direct your prevention.
Franklin Dudikoff: Living in the Ozarks, you go outside in summer, you get ticks. That's just life. Should I be more concerned?
Look out for Lone Star ticks and the infections that they can carry--human ehrlichiosis, STARI, and there've been a few cases of a newly recognized virus called Heartland virus. All pretty serious infections, definitely worth preventing.
KSB123: Originally Posted by Thomas N. Mather, Ph.D.: Probably, the most important things runners can do to stay TickSafe while running is to treat their shoes with permethrin tick repellent and, of course, do a quick check after coming out of the woods and a more thorough full-body check at least once a day.
First, a big "Thank You" for participating. I typically run on roads instead of trails, but still end up in grassy shoulders sometimes to get out of the way of cars and found a tick crawling on my leg just about a week ago. As a former backpacker, I've heard about permethrin before, but have never used it. My concern is that I've heard it is extremely toxic to cats...and we have one. Is it safe once applied or is it something where I would have to keep the shoes away from him even after the treatment has set?
The TickGuy: Great question. Hopefully, you won't let your cat lick your shoes right after applying the spray. Once it dries, I really doubt there is any risk, unless your cat has taken to sleeping for hours at a time on your treated shoes. The toxicity issues people associate with permethrin in cats appears to be more related to direct applications on the animals.
IceSlider: Why does one member out of seven in our family always get a highly disproportionate amount of ticks on her? We can go the same place and do the same stuff and she can bring half a dozen or more home while the rest of us get none. This is not an isolated occurrence either.
The TickGuy: That's really a hard question to answer. There are most likely very subtle things that this one person does that the others do not do--like the way they walk on a trail (or perhaps that person is the usual leader). Some people "run warmer" than others and that might impact the tick once it latches on. Perhaps their skin texture allows the ticks a slightly better hold. Or their movements are less quick. In dogs, we see different personalities that we've brand careful and carefree. Carefree dogs tend to get more ticks even when they walk down the same parkland paths.
gofriars: Good morning Dr. Tom. We're neighbors . . . I grew up and did most of my running in North Kingstown (into Saunderstown) prior to moving to Providence earlier this year.
I got Lyme 2 summers ago, and I'm fairly certain it was because of an unplanned bathroom trip while running. It had my on the injured reserve for about a month . . . and when I got back to running it was still uncomfortable. One symptom I still have from the Lyme (which was treated quickly) is a lack of energy. I lost my energy when I got the tick and it has never come back.This is all a long way of asking: Can I get Lyme a second time? Am I more susceptible now?
Unrelated where do you run? Thanks!
The TickGuy: Sorry that I can't really comment of medical issues. One thing to make sure of after having a diagnosed case of Lyme that was treated seemingly successfully except for the whole still feeling tired and run-down would be to rule out a co-infection, especially with the agent of human babesiosis. That malaria-like parasite is fairly prevalent in our region and would not have been susceptible to the same drug treatment as Lyme. In generally healthy people, your immune system can keep babesia parasites mostly in check although they can persist for long periods, and if present in your blood, could cause a low grade anemia. I suggest getting that checked out.
Most of my runs these days are local to the SK area; not like the old days when Sunday long runs came up your way to Wickford and back.
Roadkill Racing: What can you tell us about the Powassan virus, is this going to become as prevalent as Lyme? Also have you heard about the new VUAA1 bug repellent? Is it expected to be effective against ticks? I know it is supposed to work against a large number of flying insects not just mosquitoes.
The TickGuy: Powassan virus has been around for awhile, being maintained in a cycle between a groundhog tick and medium-sized mammals including groundhogs and skunks. Usually less than 1 case per year were reported, so it was not a huge human health problem. The newer finding is that there is a variant Powassan virus (called Lineage 2 or deer tick virus) that is adapted for transmission between deer ticks and wildlife. If this variant strain continues to adapt and efficiently is transmitted in the deer tick/rodent cycle, then we might expect to see it become a much larger human health threat.
It's way too early to know what the potential could be for the VUaa1 class of molecules as insect repellents. From the little information I found, I'm somewhat skeptical that it would have the same impact on ticks that it might have on mosquitoes. These two pests have quite different odorant receptors and it seems the VUaa1 is somewhat specific to insect receptors. This thought is somewhat supported by the general observation that DEET is not all that effective as a tick repellent yet it works well as a mosquito repellent. I guess you'll have to stay tuned.
cwoodsrun: As to toxicity to cats...my 2-cents as a veterinarian: I have only seen pyrethrin toxicity from shampoos and topicals formulated for dogs and horses that have been applied to cats. The risk from spraying shoes and running gear is likely very small.
The TickGuy: Thanks for sharing your observations regarding pyrethroid toxicity in cats. I agree that it can be toxic but not under all exposure scenarios. Like you said, apply it directly to cats and maybe there's a problem, but exposure to permethrin-treated clothing does not seem to represent a risky exposure scenario.
cwoodsrun: Permethrin spray on the shoes is the way to go although I have been lax with it lately, and a combo of gaiters and spray is an excellent way to go in high incidence areas. The shoe/ankle area is the place they most often come aboard and treating socks is sort of impractical. Or one can cut off the top of an old pair of socks and treat them and wear them as gaiters, http://www.amazon.com/dp/B00KC18AL8?psc=1
Hope this helps. I for one refuse to be frightened away from my trails by a dumb little arachnid.
The TickGuy: I love your attitude...which I share; my work is to help people manage ticks and not let ticks manage people.
jamag: Dear Dr. Mather: The information here is very helpful and your web site is terrifically informative. Thank you for your time and expertise here. What is your sense of Lyme disease in those who have been exposed, i.e. are antibody positive? Do we know if all who are exposed ultimately develop symptoms? I work in epidemiology in an area of human disease and over the years have seen more cases of Lyme, including myocarditis. Is the prevalence increasing to your knowledge?
A far more practical question: how often to spray running shoes? Thank you again.
The TickGuy: Your first question is outside of my expertise, sorry. Regarding spraying your running shoes, our general rule is to spray at least once a month during the season that the immature stage ticks are active. That means May, June, July for nymphs and August, September for larvae. Mark your calendar, buy your spray and then just do it after your run. The shoes will be dry before you need them again. If you get your shoes wet frequently, you might want to spray them a little more frequently.
One thing about technique--spray the shoes until they are wet. It'll dry and the smell does go away when the shoes dry (not sure about any nasty foot smell though).